NHS to stop covering cost of cabazitaxel for mCRPC as of November

As reported in a wide spectrum of media over the past few days (see here for example), on Friday last week the National Health Service announced that it would no longer cover the costs associated with use of cabazitaxel (Jevtana) in the treatment of metastatic, castration-resistant prostate cancer (mCRPC) through the UK’s Cancer Drugs Fund — effective as of November 1, 2015.

We have known that this was coming for a long time, so this is no surprise, but it still represents a serious loss of opportunity for at least some men with mCRPC in the four nations of the United Kingdom who are no longer responding to treatment with drugs like abiraterone acetate, enzalutamide, and docetaxel.

8 Responses

  1. Very unfortunate for our UK brothers. Hopefully we don’t see same here.

  2. This is a case of the manufacturer cutting off his nose to spite his face. With a lower drug cost, the cancellation would never have happened.

  3. I sent the following to the online prostate cancer support lists to which I subscribe:

    Men of the United Kingdom: You may or may not be aware of the following; in any event you should all rise in unison to fight this exclusion of such an important medication for men with advanced prostate cancer having shown failure of all other medications to rein in their continuing cancer development:

    NHS to stop covering cost of cabazitaxel for mCRPC as of November

  4. I predicted this last December and became certain of the cut last March, both on the basis of official NHS England documents. The first was dodgy and I warned others that this might well be intentional. When I read reputable reports last week I figured I was right. Given a skim of the NHS Decision documents about the Cancer Drug Fund, I think Zytiga is next. This won’t end here, and it won’t be limited to Simon Stevens’ NHS racket. Other articles suggest that the Fund’s functions will be brought under NICE, and that the present cut is preparatory to that. Here is the latest official NHS announcement.

  5. Dear George (and Chuck):

    Rightly or wrongly, the National Health Service has been very clear that this cut was coming for the best part of the past 18 months or so. It was not exactly unexpected. And cabazitaxel is far from being the only drug affected.

    Those of us in the “First World” who have grown accustomed to the idea that we will inevitably have access to every drug that the biopharmaceutical industry can bring to market (either through nationalized healthcare systems or through private, insurance-based systems) are going to need to realize that the economics of high-cost therapies with limited benefits for late stages of many cancers (and other disorders) isn’t working. Industry, payers, and politicians are going to need to come to some new form of shared vision. One can point fingers all over the place, but, bluntly, the numbers don’t add up.

  6. Dear Sitemaster:

    One new vision begins with the appropriation and nationalisation of all pharmaceutical firms. Let universities carry out research and let the governments buy products elsewhere if necessary. Do Simon Stevens and his American supporters — United Healthcare I think it is called — need the NHS? He might have a cushy policy elsewhere.

    At any rate, I did not know about this cut until I read that weird NHS document and started thinking eyes wide open. It was the NHS Commisioning Intentions 2015/16 document. The first official confirmation was last February or March. Likewise, this document need not describe the last stage. Who knows what will follow? I can say now that a UN group is investigating the UK’s Department for Work and Pensions as I write. A step in the right direction after about 3 years of hard work by Disabled People Against Cuts, a British group totally independent of the government. I’m a member.

  7. Dear George:

    As someone who grew up with in the NHS (and worked within it as a consultant for quite a while before moving to America in the mid 80s), I think I can tell you some things with a high degree of confidence:

    (a) Nationalizing the biopharmceutical industry is a non-starter. It wouldn’t work. All it would do is kill an industry that does (certainly) need some serious reform. Kill the industry and there will be no more useful drugs for serious disorders. Have you looked closely at the state of the biopharmaceutical industry in nations like Cuba, Venezuela, Russia, etc., recently?

    (b) Universities are very good at teaching things to people and doing research. I know of very few universities that have any sort of real track record at turning the results of that research into valuable, practical treatments for large numbers of people, complete with the necessary infrastructure to disseminate and manage the use of those treatments.

    (c) Much as I would love to see a “primary single payer” healthcare system here in America, I don’t think it will happen in my lifetime, and there is one thing that is 100% certain about all such systems. They work within fixed annual budgets. If one has to work within a fixed annual budget, then every item that is paid for is being paid for at the cost of an item one might like but that one cannot afford. It is for this simple reason that we can’t all go to the opera every night and we can’t all drive around in Maseratis — much as we might like to.

    (d) We are all going to need to start to make decisions like the one taken by the NHS in the near future. There are way too many humans on the planet for us all to go on living in the style that we would all like to be accustomed to … and getting unrestricted access to the healthcare products and services that a few of us have learned to love and take advantage of.

  8. Unfortunately, the Jevtana option is not just for men that failed docetaxel. Docetaxel has some very nasty side effects like hair loss and neuropathy. Jevtana has been used in cases where neuropathy is more important to the patient and it has been a better option for them than docetaxel. I know musicians and painters would agree. Perhaps a trial is needed for these guys?

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